Dr Derek Alan Black, OD - Medicare Optometrist in Cumming, GA

Dr Derek Alan Black, OD is a medicare enrolled "Optometrist" provider in Cumming, Georgia. He went to Southern College Of Optometry and graduated in 2013 and has 11 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Lake Lanier Eye Care, Llc, Eagle View Eye Care Llc and his current practice location is 1211 Bald Ridge Marina Rd, Cumming, Georgia. You can reach out to his office (for appointments etc.) via phone at (470) 239-6625.

Dr Derek Alan Black is licensed to practice in Georgia (license number OPT002922) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1114353232.

Contact Information

Dr Derek Alan Black, OD
1211 Bald Ridge Marina Rd,
Cumming, GA 30041-8484
(470) 239-6625
(470) 239-6626

Map and Direction




Healthcare Provider's Profile

Full NameDr Derek Alan Black
GenderMale
SpecialityOptometry
Experience11 Years
Location1211 Bald Ridge Marina Rd, Cumming, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Derek Alan Black attended and graduated from Southern College Of Optometry in 2013
  NPI Data:
  • NPI Number: 1114353232
  • Provider Enumeration Date: 09/20/2013
  • Last Update Date: 10/26/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 9133410848
  • Enrollment ID: I20160627001622

Medical Identifiers

Medical identifiers for Dr Derek Alan Black such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114353232NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist OPT002922 (Georgia)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lake Lanier Eye Care, Llc59910191842
Eagle View Eye Care Llc72143482594

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Derek Alan Black allows following entities to bill medicare on his behalf.
Provider NameLake Lanier Eye Care, Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1013312453
PECOS PAC ID: 5991019184
Enrollment ID: O20150731016229
Provider NameEagle View Eye Care Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1508495474
PECOS PAC ID: 7214348259
Enrollment ID: O20210308000835

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Derek Alan Black is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Derek Alan Black, OD
1211 Bald Ridge Marina Rd,
Cumming, GA 30041-8484

Ph: (470) 239-6625
Dr Derek Alan Black, OD
1211 Bald Ridge Marina Rd,
Cumming, GA 30041-8484

Ph: (470) 239-6625

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.